Individual
JACQUELINE A. RENDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
333 S 900 E, SALT LAKE CITY, UT 84102-2310
(801) 535-8163
(801) 355-4011
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 535-8163
(801) 355-4011
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
30914
AZ
207V00000X
Obstetrics & Gynecology Physician
Primary
7583334-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
797277
—
AS
01
—
AZ0741230
BCBS
AZ
Enumeration date
10/11/2006
Last updated
03/16/2011
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